论文部分内容阅读
目的分析阴道镜检查及阴道镜下宫颈活检在宫颈上皮内瘤变(CIN)疾病诊断中的应用价值。方法收集2014年1月~2016年8月于我院进行治疗的367例CIN患者作为研究对象,以宫颈环形电切术(LEEP术)后组织病理作为确诊依据,比较阴道镜下宫颈活检病理与LEEP术后病理的符合率及CIN患者中不同类型宫颈转化区对阴道镜指导活检的影响。结果阴道镜指导下宫颈活检与LEEP术后组织病理诊断总体符合率为79.56%,其中,Ⅰ,Ⅱ型转化区活检诊断与LEEP术后组织病理诊断符合率91%;367例患者中诊断不足者50例(13.6%),其中宫颈浸润癌27例(7.36%);Ⅰ,Ⅱ型转化区活检准确率高于Ⅲ型转化区活检准确率,差异有统计学意义(P<0.01)。结论阴道镜下宫颈活检对CIN的诊断准确性高,具有较高的临床应用价值,可作为基层地区CIN的筛查方法。不满意阴道镜下宫颈活检准确率低,易漏诊宫颈癌,建议综合考虑患者HPV感染类型、年龄及生育要求等决定是否直接行LEEP术诊治宫颈癌。
Objective To analyze the value of colposcopy and colposcopic biopsy in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods 367 patients with CIN who were treated in our hospital from January 2014 to August 2016 were enrolled in this study. Tissue pathology after LEEP was diagnosed, and pathology of colposcopic biopsy was compared with that of colposcopic biopsy The coincidence rate of LEEP postoperative pathology and the effect of different types of cervical conversion zone on colposcopy guided biopsy in CIN patients. Results The total coincidence rate of cervical biopsy under the guidance of colposcopy and histopathological diagnosis after LEEP was 79.56%. The coincidence rate of biopsy of type Ⅰ and type Ⅱ transformation zone with the histopathological diagnosis of LEEP was 91%. Among the 367 patients with undetected There were 50 cases (13.6%) with invasive cervical carcinoma in 27 cases (7.36%). The biopsy accuracy of type Ⅰ and type Ⅱ transformation zone was higher than that of type Ⅲ transformation zone (P <0.01). Conclusions Colposcopic cervical biopsy has high diagnostic accuracy for CIN and high clinical value. It can be used as a screening method for CIN in primary area. Not satisfied with colposcopy cervical biopsy accuracy is low, easy to misdiagnose cervical cancer, it is recommended that patients consider the type of HPV infection, age and fertility requirements and other decisions whether direct LEEP diagnosis and treatment of cervical cancer.